PB1761: ACUTE LEUKEMIA STATISTICS IN ARMENIA DURING 2010-2020
Authors: L. Harutyunyan, L. Sahakyan, Y. Hakobyan
Journal: HemaSphere (2022)

Background: Acute leukemia (AL) is a group of hematological malignancies, the types of which include lymphoblastic and myeloblastic variants. In USA 60530 new cases of leukemia are diagnosed during 2020, of which about 30% is Acute myeloid leukemia (AML). The prevalence of AML in USA is 4.3:100000 per year during 2013-2017, while death rate is 2.8:100000 during 2014-2018. Compared to AML, Acute lymphoblastic leukemia (ALL) in 80% cases occurs in children. Being a malignant transformation and proliferation of lymphoid progenitor cells in the bone marrow, blood and extra medullary sites, ALL represents a devastating disease when it occurs in adults. The incidence of ALL follows a bimodal distribution, with the first peak occurring in childhood and a second peak occurring around the age of 50. While dose intensification strategies have led to a significant improvement in outcomes for pediatric patients, prognosis for the elderly remains very poor. Despite a high rate of response to induction chemotherapy, only 30–40% of adult patients with ALL will achieve long-term remission. Aims: The aim of the current study was a comprehensive analysis of AL, i.e., their prevalence and incidence in Armenia for the period of 2010-2020. Methods: The main data source for this study was outpatient and dispensary cards, hospitalization journals, as well as clinical data from the Register of Blood Diseases of the Hematology Center after. prof. R. Yeolyan. This information has been supplemented by the data from National Oncological Center after V.A. Fanarjyan as well as from death registration service at Ministry of Justice RA. Patients with newly diagnosed AL who were older than age 18 years, considered fit for intensive therapy, and diagnosed and treated in Armenia from January 1, 2010, until December 31, 2020, were included. Demographic indicators were derived from the database of Statistical Committee of Armenia (https://www.armstat.am/en/). Results: ALL incidence did not significantly change, however AML incidence significantly increased in women, with estimated annual percentage change (EAPC) of 2.6% during the whole period, and in men since 1998, with EAPC of 3.2%. Mortality rates were stable for both lymphoid and myeloid leukemia in both sexes. The median number of AL is 88.7 in Armenia during 2010-2020, making the highest number of patients 113 in 2015. The prevalence in Armenia was 2.6:104 during 2010-2012, and 2.7:104 for the next year. In 2014 it was 3.3:104. In 2016, 2017, 2018, 2019 the prevalence was 2.9:104, 3.2:104, 3:104, 2.8:104, respectively. The highest prevalence was admitted in 2015, making 3.8:104, otherwise the lowest was in 2020, making 2.4:104. Median prevalence for 10 years is 2.9:104 in Armenia. The median number per year of acute promyelocytic leukemia (APL) patients is 3 during 2010-2020, and the APL median prevalence for the same span is 0.1:104. 10-year median prevalence of ALL and AML is 0.6:104 and 1.12:104, respectively. Summary/Conclusion: Compared to USA, there are lower incidence trends in Armenia, however in 2015 rates were similar. The lack of declines of leukemia incidence and mortality could be attributed to late introduction of optimal therapies. As currently the most up-to-date diagnostics and treatments are available and covered by health insurance, we expect more favorable trends in the future.